Individual provider Active NPI

Elena R Jauregui, MD

  • Family Medicine Physician
  • Elizabeth, NJ
National Provider Identifier
1265429781
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MA61659 Issued in NJ
Practice address
609 Morris Ave
Elizabeth, NJ 07208-1711
Phone
(908) 351-1700
Fax
(908) 351-2323
NPI assigned
Sep 30, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MA61659 NJ Primary
Pediatrics Physician 208000000X MA61659 NJ

Addresses

Primary practice location

609 Morris Ave
Elizabeth, NJ 07208-1711

Mailing address

609 Morris Ave
Elizabeth, NJ 07208-1711
Phone (908) 351-1700

Other identifiers 1

IdentifierTypeStateIssuer
6708005MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120103000576 NJ Practitioner - Family Practice 0244406833 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA61659NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Hospital Opco LLC Current Accepting new patients
Optum Medical Care of New Jersey PC Pediatrics CurrentSince Oct 1, 2020 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Oct 1, 2020 Accepting new patients
Mariposa Health Center, LLC Family Medicine PastSince Jul 20, 2010 Accepting new patients
A.G. Dikengil, MD, PA Past Accepting new patients
Carmen Delcueto MD & Associate Past Accepting new patients
Riverside Medical Group PastSince Nov 12, 2011 Accepting new patients

Locations

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

714 10th St
Secaucus, NJ 07094
Phone (201) 863-3346

Interoperability endpoints

  • Direct secure messaging: elena.jauregui@direct.christhospital.md

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1265429781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 MORRIS AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081711",
            "telephone_number": "908-351-1700",
            "fax_number": "908-351-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 MORRIS AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081711",
            "telephone_number": "908-351-1700",
            "fax_number": "908-351-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAUREGUI",
        "first_name": "ELENA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA61659",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MA61659",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6708005",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

Verify at the official NPI Registry.